Provider Demographics
NPI:1568465763
Name:FRANK, BRANNON (MD)
Entity type:Individual
Prefix:
First Name:BRANNON
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 ADDISON CIR STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6049
Mailing Address - Country:US
Mailing Address - Phone:214-983-0300
Mailing Address - Fax:
Practice Address - Street 1:401 W SLAUGHTER LN STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1774
Practice Address - Country:US
Practice Address - Phone:512-888-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0078207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170426401Medicaid
TX170426403Medicaid
TX170426401Medicaid
TX8L23500Medicare PIN
TX8C9573Medicare PIN